Healthcare Provider Details

I. General information

NPI: 1487356911
Provider Name (Legal Business Name): SHEENA CRUZ MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E LUGONIA AVE STE F
REDLANDS CA
92374-2550
US

IV. Provider business mailing address

322 N MARIN PRIVADO
ONTARIO CA
91764-1233
US

V. Phone/Fax

Practice location:
  • Phone: 661-406-9163
  • Fax:
Mailing address:
  • Phone: 661-406-9163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA210373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: